What are Treatment Options for Unstable Angina?

Unstable angina, sometimes known as acute coronary syndrome, is a condition where the blood does not get enough blood flow and as a consequence, oxygen. It may in the long haul lead to heart attacks. Angina is a type of chest discomfort caused by poor blood flow through the coronary vessels of the myocardium.

Mainly marked by a crushing pain in the chest area, pain may also be encountered in the shoulders, neck, back and arms. This resulting pain is caused by the inadequate flow of blood, which deprives the heart of oxygen. The main cause of unstable angina is narrowing of coronary arteries by fat build up known as atherosclerosis which can rapture causing injury to the coronary blood vessel resulting in blood clotting in the heart which blocks flow of blood to the myocardium.

Unstable angina is an emergency situation and upon encountering its symptoms one should rush to the emergency room as soon as possible. Encountering new, worsening or persistent chest discomfort could mean one is having a heart attack. This also puts one at an increased risk of having severe cardiac arrhythmias or cardiac arrest which could lead to sudden death. There is also another unstable form of angina known as prinzmetal angina.

Causes of unstable angina

Unstable angina results from blood clots that partially or totally block an artery. These clots may form, partially dissolve and later form again and angina can occur each time a clot blocks blood flow in an artery.

Symptoms of unstable angina

  • Pain and discomfort in the chest area.
  • It occurs when one is resting, sleeping or with little physical exertion.
  • It comes as a surprise.
  • It may last longer than stable angina.
  • Getting some rest or taking medicine does not always relieve it.
  • It may get worse over time.
  • It can eventually lead to a heart attack.

Treatment for unstable angina

One needs to have a conversation and a proper check up with a health provider to find out the blocked parts of the coronary arteries by performing a coronary catheterization.  During the cardiac catheterization a catheter is guided through an artery present in the arm or leg and into the coronary arteries. It is then injected with a liquid dye through the catheter. A high speed x-ray machine records the course the dye takes as it flows through the arteries and allows doctors to trace the flow of the dye and identify blockages in the coronary arteries. An evaluation on the health of the heart can be done during cardiac catheterization.

After the procedure has been carried out, the cardiologist will ideally discuss with the patient the available treatment options depending on the extent of the blockage the catheterization revealed.

Percutaneous coronary intervention (PCI)

This procedure may be required to open a blocked coronary artery. This procedure is carried out by undergoing a coronary catheterization which is followed by using a catheter that has an inflatable balloon at the tip. The inflated balloon squeezes open the fatty plaque deposit that is located on the inner lining of the coronary artery. After that, the balloon is deflated and the catheter is withdrawn. A stent is inserted following the procedure to keep the coronary vessel open and allow for improved blood flow into the heart muscle.

Coronary arteries bypass graft surgery

This procedure is done depending on the extent of the coronary artery blockages and medical history of the patient. In this procedure, blood is re-routed to another blood vessel to avoid it flowing through the blocked vessel forming a detour of sorts.

 Featured image: DepositPhotos/michaeljung


Posted on May 22, 2023